UNIVERSITY OF WYOMING’S EXPERIENCE WITH(OUT) MEDICAL AMNESTYLena Edmunds, MPH, CHES

AWARE Program Coordinator

MEDICAL AMNESTY JOURNEY AT UW

Process that lasted nearly 1 ½ years (Nov 2006 to March 2008)

Student-initiated discussions about Medical Amnesty began in November 2006

Very controversial subject and coalition divided

Formed a sub-committee, reviewed other policies, collected UW-specific data, consulted with other schools, presented to student government

Ultimately agreed on a resolution not to pursue a medical amnesty policy at UW

UNIVERSITY OF WYOMING Public land grant university Only 4-year institution of higher education in Wyoming Approximately 10,000 students Located in southeast corner of Wyoming, in Laramie, population

29,000. Student Health Service on campus open M-F, 8-5 Campus police department with sworn officers

ALCOHOL ISSUES AT UW UW

NCHA Data 2007

Reference Group Data 2007

Students who don’t drink 17.2% 18.6% Students who report alcohol is negatively affecting academics

11.6% 7.7%

Students binge drinking within past two weeks

47.5% 38.2%

Students driving after having 5 or more drinks in past 30 days

12.2% 5.8%

Average BAC of people arrested by UWPD

0.19% N/A

Sources: National College Health Assessment, Spring 2007, 2007Wyoming Association of Sheriffs and Chiefs of Police, May 2007

ALCOHOL ISSUES AT UW CONT’D

Average of 298 students per year referred to AWARE Program for alcohol education/prevention services

Hospital emergency room admissions: Nearly half of people admitted to ER for alcohol

poisoning in 2005 were UW students Eighteen percent were under age 21

ALCOHOL VIOLATIONS AT UW

Student receives ticket from UWPD, and/or

Judicial file started, student sanctions include: paper, community service, AWARE Program

Student receives ticket

Referred to AWARE by local judge

Sometimes judicial consequences

On-Campus Off-Campus

A-TEAM COALITION A-Team Campus-Community Coalition

Membership includes students, staff, administrators, community members

Mission: develop, recommend, and assess best practices in policy, prevention/intervention, and enforcement to reduce underage drinking and excessive alcohol use

STEP ONE: RESEARCH

Findings: field lacks adequate research about medical amnesty policies

Decision: survey UW students to help make data-driven decisions

UW STUDENT SURVEY RESULTS

Questions added to NCHA, administered to a random, stratified sample in Spring 2007

N=336 (18-20 year olds) 83.3% had taken care of a drunken friend in

last 12 months 14.9% thought about calling for medical help

12% actually called for medical help

RESULTS, CONT’D

Didn’t call: Didn’t want to get that person in trouble (24.5%) Didn’t want to get self in trouble (20.4%) Wasn’t sure person was sick enough (60.0%) Repeatedly checked on person (80%) Turned the person on his/her side and left

him/her alone (29.2%) I made sure I stayed with the person (69.4%)

COMMENTS

“This kid had done it before, so we rolled him half in, half outta the shower and checked up on him from time to time.”

“People get drunk all the time, they don’t necessarily need to go to the hospital.”

“I am trained for first aid and CPR.” “She wasn’t that sick.” “He can handle his own, and the bar still

served him so…”

STEP 2: REVIEW POLICIES

School policies Cornell, University of Pennsylvania, Emory,

Hanover College, Keystone College, Lafayette College, Dartmouth, University of Colorado-Boulder, College of William and Mary

State legislation Colorado: House Bill 05-1183 (6/3/2005) North Dakota (Century Code Title 5. Alcoholic

Beverages Chapter 5-01-09.)

COLORADO LEGISLATION

An underage person and one or two other persons shall be immune from criminal prosecution…if they establish the following: One of the underage persons called 911 and

reported that another underage person was in need of medical assistance due to alcohol consumption

The underage person who called 911 and, if applicable, one or two other persons acting in concert with the underage person who called 911 provided their names to the 911 operator

COLORADO LEGISLATION CONT’D

The underage person was the first person to make the 911 report; and

The underage person and, if applicable, one or two other persons…remained on the scene with the underage person in need of medical assistance until assistance arrived and cooperated with medical assistance and law enforcement personnel on the scene.

NORTH DAKOTA

Similar to Colorado’s legislation Maximum number of individuals that may be

immune for any one occurrence is five, including the person in need of medical assistance

OTHER SCHOOLS

More private than public Twenty-four hour health service on campus No formal judicial/disciplinary actions taken,

but “conditions” Can still receive legal consequences Does not preclude disciplinary action

regarding other conduct violations (i.e. property damage, assault, etc.)

STEP 3: PRESENTATIONS

A-Tem Presentation to UW student government Invitation to attend presentation by Ft. Collins PD Very little interest expressed

Presentation by City of Ft. Collins Police Officers (home to Colorado State University) to A-Team (Dec 2007) Very few instances where it has been used (less

than 50 since June 2005), mostly officer-instigated

Not well known among officers nor underage individuals

Poor student involvement/interest

MORE QUESTIONS THAN ANSWERS

Jurisdiction? (campus, city, county, state) Definition of “Trouble”? Amnesty from what? No ticket? No judicial

sanctions? No education? Who? (Intoxicated student? Student who

called? Others?) Legal versus judicial?

Changes in state statutes? Officer discretion?

CONCLUSIONS

Process brought many constituencies together to agree on a resolution Written report of findings Increased education on signs/symptoms of

alcohol poisoning Social marketing on importance of seeking help

for a dangerously intoxicated person If policy were pursued, should be spearheaded

by students Should be a statewide initiative, pushed through

the Wyoming legislature

UW WITHOUT MEDICAL AMNESTY

Student transported to hospital Sometimes given a ticket, sometimes not If on campus, a judicial file is opened and

they are sanctioned to receive educational services through AWARE Program

UNANTICIPATED POSITIVE OUTCOMES AND FUTURE DIRECTIONS

More people on board that became experts Came to agreement on a controversial

subject Educational process for all Future medical amnesty possibility? Increased education on alcohol poisoning

signs Will continue to collect data with NCHA

survey Discussion among senior administrators,

legal counsel

MEDICAL AMNESTY POLICY ASSUMPTIONS

“Students can identify symptoms of alcohol poisoning

Students understand the risk associated with the symptoms of alcohol poisoning

Students responsible for help-seeking are sober enough to adequately judge the level of risk involved

Students are currently not calling for help due to fear of getting in trouble with the university

Students will be more likely to call for help if they are assured that they will not get in trouble.”

Source: Oster-Aaland and Eighmy (2007). Medical Amnesty Policies: Research is Needed. NASPA Journal, Vol. 44, no. 4.

CONTACT INFORMATION

Lena Edmunds, MPH, CHESAWARE Program CoordinatorUniversity of Wyoming1000 E. University Ave., Dept. 3708Laramie, WY 82071Phone: (307) 766-2187Email: ledmunds@uwyo.edu